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Several studies have found a reduction in hippocampal volume in borderline personality disorder (BPD) patients.
In order to investigate the degree to which comorbid posttraumatic stress disorder (PTSD) could account for reduction in hippocampal volume in these patients, we conducted a systematic review and meta-analysis of studies that compared hippocampal volume in BPD patients with and without PTSD relative to healthy controls.
Seven articles, involving 124 patients and 147 controls, were included. We found a statistically significant reduction for the left and right hippocampus. Data from the four studies that discriminated BPD patients with and without PTSD indicate that hippocampal volumes were reduced bilaterally in BPD patients with PTSD, relative to healthy controls, but that results were mixed for BPD patients without PTSD, relative to healthy controls.
Results from this meta-analysis suggest that hippocampal volumes are reduced in patients with BPD, relative to healthy controls, but particularly in cases in which patients are diagnosed with comorbid PTSD.
The HCV has been associated with significant impairment of quality of life, irrespective of the degree of liver injury. The association of this disease with psychiatric comorbidities, especially depression, has been well described in the scientific literature. However, despite also significantly affect the quality of life of individuals, the Posttraumatic Stress Disorder (PTSD) has not been well studied in this population.
Evaluate whether individuals perceive the liver disease as a potentially traumatic experience and investigate the impact of PTSD diagnosis on health-related quality of life in hepatitis C virus-infected subjects.
We conducted a cross-sectional survey of 127 consecutive hepatitis C-infected outpatients. We investigated Traumatic Experiences and the subject's perception about the disease using the Trauma History Questionnaire. PTSD and others psychiatry diagnoses were assessed trough M.I.N.I. PLUS. Quality of life was assessed by the Short-Form 36.
Approximately 38.6% of the patients perceived the hepatitis C as a traumatic experience, 60.7% had PTSD diagnosis. It were no associate with the disease severity (been eligible for transplant), however there was a significant association with diagnosis of PTSD (p = 0.003). Roughly 22% of the sample showed PTSD diagnosis. PTSD imposed a significant impairment in quality of life of individuals in seven of the eight domains in the bivariate and multivariate analysis. This difference remained significant after adjustment for covariates such as major depressive disorder comorbidity.
The results suggest high prevalence of PTSD diagnosis in VHC infected patients and it impose impairment in their quality of life.
Leprosy is an infectious disease with high physical disability and is strongly associated with chronic pain, since there may be significant impairment of the peripheral nervous system. Additionally, the stigma associated with the label of leprosy persists and imposes a high social commitment of the disease.
Describe the frequency of psychiatric comorbidities in leprosy patients and check if they had been previously diagnosed and were in psychiatric care.
The study was conducted with a sample of 120 leprosy patients treated at two hospitals for leprosy: Hospital Dom Rodrigo de Menezes and University Hospital of Federal University of Bahia, in Salvador, Bahia, Brazil. Survey participants were older than 18 years of age, had confirmed the diagnosis of leprosy and were in antimicrobial treatment. Patients were evaluated face to face with a socio-demographic questionnaire and the Mini-International Neuropsychiatric Interview (MINIPlus) in Portuguese. The period of data collection was limited from October 2009 to June 2012.
The assessment using the MINI-Plus showed that 34 (28.33%) patients did not have any psychiatric diagnosis and 86 (71.66%) had at least one. Of these 86 patients, 25(20.83%), met the criteria for one diagnosis, 26 (21.66%) had two diagnoses and the rest, 35 (29.16%), had three or more psychiatric diagnoses. All patients with moderate or high risk for suicide had one or more psychiatric comorbidities.
Leprosy patients have a high prevalence of psychiatric comorbidities. Beyond that, most of them had no previous psychiatric diagnosis and the absolute majority were not in treatment.
Bipolar disorder (BD) commonly co-occurs with anxiety disorders (AD) and this comorbidity has been associated to worse clinical outcomes in BD patients. However frequency and clinical outcomes data might be biased once some of them had been originated from acutely ill bipolar patients as well as those in remission.
To assess AD in bipolar sample in order to know if this frequency vary according illness phase and identify possible clinical outcomes related to this comorbidity.
A population of 355 outpatients with bipolar I disorder were evaluated using structured instruments (SCID). The sample was split into four groups considering the illness phase and the presence of AD: euthymic without AD (euthymic/non- AD); euthymic with AD (euthimic/AD); non-euthymic without AD (non-euthymic/non-AD) and non-euthymic with AD (noneuthymic/ AD) groups. Clinical and socio-demographics differences between the groups were compared through bivariate analysis.
There was a progressive and significantly increasing in some worst clinical outcomes frequency, such as rapid cycling, suicide attempts, substance and alcohol use disorders, history of antidepressant use and decreased scores in all domains of QoL, from control group (euthymic /non-AD) through out intermediate group (non-euthymic/non-AD) until the group most affected (non-euthymic/AD). Both euthymic/non-AD and euthimic/AD groups did not differ.
We identified a group of severe bipolar patients that have worse clinical outcomes, and among them, the anxiety comorbidity. But, contrary to what has been stated, AD appears to be related with poor bipolar prognosis only when other severity clinical factors are presents.
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